Clinical Coder II
About The Position
The Department of Ophthalmology is seeking a surgical coder to bill professional medical fees for clinical faculty. This incumbent will extract billable services from the patient charts, apply appropriate Current Procedural Terminology (CPT) and International Classification of Diseases (ICD-10) codes and enter these services in the EPIC billing system for submission for ocular operative procedures and consulting services. Work closely with faculty, fellows, and residents to provide education on correct coding, proper documentation to maximize physician reimbursement, and ensure compliance with federal and state regulations.
Requirements
- High school diploma or equivalent and three years of professional medical coding experience. Appropriate college coursework or vocational/technical training may substitute at an equivalent rate for the required experience. Certified Professional Coder (CPC)/American Academy of Professional Coders (AAPC) or one of the following required: Certified Coding Specialist (CCS-P)/Certified Coding Assistant (CCA)/Registered Health Information Administrator (RHIA).
- CPC certification must be obtained within 6 months of hire.
Nice To Haves
- Professional behavior and demeanor.
- Strong written and verbal communication skills.
- Knowledge of medical terminology, coding systems (ICD-10, CPT, HCPCS), and insurance and clinical billing policies and procedures.
- Ability to interpret and organize medical data.
- Familiarity with EPIC.
- Experience with billing and coding in a healthcare setting specifically related to ophthalmology.
- Ophthalmology and/or Epic experience preferred.
Responsibilities
- Reviews ophthalmology provider progress and procedure reports through electronic medical record system for extraction of billable services for all patients which may include inpatient attending services and consultation services.
- Applies appropriate CPT and ICD-10 codes and confirms adequate teaching provider documentation such as attestations and time-based statements.
- Enters charges into the electronic system while ensuring clean claim submission to include working any edits that may generate and appear in the work queue.
- Responds to the University of Florida Physicians billing group on information requests submitted through the follow-up work queue on all coding denials related to specialty.
- Investigates coding issues through all available resources such as professional associations, federal and private payer guidelines, and specialty coding network.
- Conducts research of denials, report trended claim issues and identify opportunities for improvement.
- Compiles documentation for appeals to substantiate reimbursement including coding language, medical record documentation, and literature referencing specific payer guidelines supporting services billed.
- Performs various administrative and clerical duties required to support coding and billing functions for the Department of Ophthalmology.
- Participates in providing guidance and education to billing providers regarding coding, documentation, reimbursement, and compliance.
- Provides ongoing reviews and feedback regarding any coding and/or documentation issues that can impact reimbursement.
- Informs department leadership and clinical faculty of changes in coding and reimbursement.
- Attends continuing education courses, seminars, conferences, and meetings.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
Number of Employees
1-10 employees
